Medsource EMS Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1000142 Issued in TX

Legal business name

MEDSOURCE EMS INC.

Practice address

10101 Harwin Dr
Suite 324
Houston, TX 77036-1687

Phone

(713) 270-0700

Fax

(713) 270-8331

NPI assigned

Jun 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicola Abiola Fagbeyiro

Title

Ceo

Phone

(713) 270-0700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1093974545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 S. LOOP WEST",
            "address_2": "SUITE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545613",
            "telephone_number": "713-669-1090",
            "fax_number": "713-669-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 HARWIN DR",
            "address_2": "SUITE 324",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361687",
            "telephone_number": "713-270-0700",
            "fax_number": "713-270-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE EMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "FAGBEYIRO",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_middle_name": "ABIOLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-270-0700"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "1000142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF HEALTH",
            "identifier": "1000142",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Houston, TX
• Providers in Houston, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.